Senior Claims Analyst

This role supports reporting, analytics, and process improvements across the claims lifecycle. The Senior Claims Analyst builds claims/encounter reporting, reconciles cross-system data for accurate claim status tracking, and partners with product, engineering, finance, and operations to improve submission performance and workflows.

• Build and maintain reporting to track the full claims lifecycle from submission to payer response
• Create self-service tools for Operations, Finance, and Client Success
• Reconcile data across systems to ensure accurate claim status tracking
• Act as an SME on claims structure, clearinghouse workflows, and payer responses
• Support new payer implementations including workflow setup and validation

Focuses on claims and encounter reporting using SQL and data analytics. Works with payer configuration, clearinghouse workflows, professional claim formats (837P), and remittance advice (835) to troubleshoot claim issues, validate fixes, and support payer go-lives with monitoring and audits.

The ideal candidate is a senior analytics and claims professional with 6+ years of systems analyst or business analyst experience and strong SQL/data reporting skills. They have hands-on provider-side claims and revenue cycle experience, including 837P and 835 understanding, and can improve end-to-end claim workflows through reconciliation, monitoring, and cross-functional partnership.